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Study protocol: home-based telehealth stroke care: a randomized trial for veterans.

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Date
2010-06-30
Authors
Chumbler, NR
Rose, DK
Griffiths, P
Quigley, P
McGee Hernandez, N
Carlson, KA
Vandenberg, P
Morey, MC
Sanford, J
Hoenig, H
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Abstract
BACKGROUND: Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR) intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. METHODS: We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT) that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a) TR; or (b) Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. DISCUSSION: For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and increase efficiency. This may be particularly relevant when patients live in remote locations, as is the case for many veterans. TRIAL REGISTRATION: Clinical Trials.gov Identifier: NCT00384748.
Type
Journal article
Subject
Activities of Daily Living
Aged
Aged, 80 and over
Community Health Services
Delivery of Health Care, Integrated
Disability Evaluation
Follow-Up Studies
Hospitals, Veterans
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Satisfaction
Stroke
Stroke Rehabilitation
Telemedicine
Telephone
United States
Veterans
Videotape Recording
Permalink
https://hdl.handle.net/10161/4379
Published Version (Please cite this version)
10.1186/1745-6215-11-74
Publication Info
Chumbler, NR; Rose, DK; Griffiths, P; Quigley, P; McGee Hernandez, N; Carlson, KA; ... Hoenig, H (2010). Study protocol: home-based telehealth stroke care: a randomized trial for veterans. Trials, 11. pp. 74. 10.1186/1745-6215-11-74. Retrieved from https://hdl.handle.net/10161/4379.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Hoenig

Helen Marie Hoenig

Professor of Medicine
1. General Focus and Goals of Research: Dr. Hoenig's research focuses on rehabilitation, and more specifically on assistive technology and teletechnology. Patient populations of interest include geriatric patients with diverse medical problems including stroke, spinal and/or musculoskeletal disorders. 2. Specific Approaches or Techniques: Randomized controlled trials, epidemiological studies including large data base analyses and survey research. Clinical trials include studi
Morey

Miriam C. Morey

Professor in Medicine
The general focus of Dr. Morey's work is exercise and aging. All of her research examines how physical activity, exercise training, or physical fitness influence the physical functioning and/or pyschosocial quality of life of older adults. She directs a supervised hospital-based program for older adults, which is used to examine longitudinally the effects of exercise training on the musculoskeletal, articular, and cardiorespiratory systems. Furthermore, she has a number of studies that e
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